The Value of Myocardial Perfusion Imaging with Tc-99m MIBI for the Prediction of Perfusion Improvement after Percutaneous Transluminal Coronary Angioplasty

Percutaneous transluminal coronary angioplasty (PTCA) is an effective method for revascularizing of stenotic coronary vessels. Lack of response to this treatment, either in symptomatic or asymptomatic patients, is usually due to incomplete revascularization, restenosis, and/or irreversibility of myocardial perfusion. Introduction of a noninvasive method with high predictive value for diagnosis of reversibility in ischemic myocardium is of high importance to determine the patients who will benefit from PTCA. Sixty patients with one or two vessel disease, who were candidates for PTCA and had a successful PTCA (proved by post- revascularization angiography), enrolled the study. For all patients myocardial perfusion imaging (MPI) was performed before PTCA in stress and rest phases. MPI was repeated in stress and rest phases within 6 months after PTCA. The predictive values of pre-PTCA scan for the diagnosis of reversibility and prediction of perfusion improvement after PTCA were evaluated. Perfusion improvement after PTCA was noted in 52 of 60 patients (86.7%). The positive predictive value of pre-intervention MPI for diagnosis of reversibility was 94.3% and the corresponding negative predictive value was 71.4%. Myocardial perfusion imaging may play an important role for accurate prediction of perfusion improvement after percutaneous transluminal coronary angioplasty.